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A survey-based study about burnout among postgraduate medical trainees: implications for leaders in healthcare management
No full textIntroduction: The goal of the study is to assess burnout among postgraduate medical trainees, evaluate the association with sociodemographic features and offer potential wellness strategies for leaders responsible for their education, training, management, and wellbeing. Methods: The Oldenburg Burnout Inventory was used. The web-based, voluntary, and anonymous survey was sent to postgraduate medical trainees from various specialties and all years of training in a tertiary medical center in Beirut, Lebanon. Additional questions were added after the survey regarding reporting channels for burnout and possible interventions for wellbeing. Results: The total number of valid responses are 188. The prevalence rates of high burnout are 37.2% for disengagement and 51.1% for exhaustion. There is a significant difference between the mean of exhaustion and gender (p = 0.003). There is a significant difference between the mean of disengagement and year of training (p = 0.017). There is a significant difference between the mean of exhaustion and year of training (p = 0.029). There is a significant difference between the frequency of disengagement and year of training (p = 0.027). Conclusion: The study reveals how postgraduate medical training program is impacted by the existing challenges from social, health, and financial standpoint, along with the instabilities encountered such as multiple wars and port blast in 2020 and how these variables aggravate burnout. Burnout severely impacts the education and training of PGMT and promoting wellbeing can help reverse the process. Findings contribute to establishing effective strategic interventions for leaders in healthcare management to adopt. Copyright © 2023 Yacoubian, Demerouti, Degheili and El Hajj
Electromagnetic Reconfiguration Using Stretchable Mechanical Metamaterials
No full textResponse to environmental thermomechanical inputs in applications that range from wearable electronics to aerospace structures necessitates agile communication systems driven by reconfigurable electromagnetic structures. Antennas in these systems must dynamically preserve acceptable radiation characteristics while enabling on-demand performance reconfiguration. However, existing reconfiguration mechanisms through stretchable conductors rely on high-strain behavior in soft substrates, which limits their applicability. Herein, this work demonstrates the use of mechanical metamaterials for stretchable conductors and dielectrics in antennas. Metamaterials allow conductor stretching up to 30% with substrate base material tensile moduli ranging from 26 MPa to 44 GPa. It is shown, through several antenna designs, that mechanical metamaterials enable similar frequency reduction upon stretching as monolithic conductors, while simultaneously providing a miniaturization effect. The conductor patterning, furthermore, provides control over coupling between mechanical stretching and electromagnetic reconfiguration. This approach enables designing reconfigurable antenna functionality through metamaterial geometry in response to arising needs in applications ranging from body-adapted electronics to space vehicles. © 2023 The Authors. Advanced Science published by Wiley-VCH GmbH
PERSONALIZATION OF AUTOCOMPLETE FRAMEWORK
No full textRemote controlling robots without any automated help is difficult due to various limitations. Autocomplete enhances teleoperation by recognizing operator intentions from the input of the user and automating motions when instructed. Such an approach can improve the system performance and reduce the load on the operator. Usually, recognizing operator-intended motions is achieved using pre-trained Deep Learning (DL) models. In this thesis, we introduce personalization to the autocomplete teleoperation framework when new operators take over by customizing the DL model using incremental learning with partial feedback. This approach allows the model to adapt to the specific operator in a relatively short period. Also, we tackle the problem of concept drift that arises in real-life applications; the data distribution of already learned classes may change in unforeseen ways as new observations of these classes come sequentially over time. We create and update an exemplar set using new observations of the classes online so that the model can be trained to adapt to the new observations. Several scenarios have been evaluated to balance the speed of learning with the accuracy of the model. The results demonstrate the effectiveness of the proposed models and their advantage in adapting to the specific operator where the personalization framework reduced the prediction mistakes of the DL model by 46\% while maintaining the advantages of autocomplete by reducing teleoperation speed and enhancing motion smoothness
Office-based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients
Get PDFObjective: To investigate the effect of office-based blue laser therapy of vocal fold polyps on voice. Methods: The medical records and video recordings of patients who underwent office-based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office-based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index-10 (VHI-10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. Results: A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male-to-female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid-third of the vocal fold. All patients who presented for follow-up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI-10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). Conclusion: Office-based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. Level of Evidence: 4 Laryngoscope, 133:2712–2718, 2023. © 2023 The American Laryngological, Rhinological and Otological Society, Inc
Building Beirut: an Account of Post-War Homes, their Builders, and a Transforming City
No full textThis is a thesis about housing in Beirut: It inquires specifically about the characteristics of the housing stock produced in Municipal Beirut during the post-civil war era, and how these characteristics were influenced by public policies. It focuses further on high-end development, reflecting on their impact on the city and the developers who have driven this form of production. The thesis argues that market enabling policies set in place in post war Lebanon resulted in the production of a housing stock that increasingly serves as an asset to developers and property owners, rather than responding to the increasing demand for affordable housing. This thesis further shows the significant role of the high-end segment in driving residential development trends: an increased production of luxurious, large, and empty apartments coveted as exchangeable assets the distribution of which has contributed to spatial division in the city. The findings finally suggest that the housing production sector is concentrated in the hands of a group of well-established development moguls who leverage social and political networks, and consequently financial networks to push their activities and maximize their profit.
This research falls with the Beirut Urban Lab’s larger body of work, specifically the Beirut Built Environment Database (BBED), and it articulates its description of the built environment – and its production – based on the data collected and analyzed as part of this project. As such, the thesis contributes in improving knowledge about Beirut’s ongoing transformation, mapping how housing production in the 1996-2018 period has impacted the city. It further contributes to the development of methodologies of studying urban transformations in cities of the Global South where data is scarce
Quantum Genetic Algorithm for the Design of Miniaturized and Reconfigurable IoT Antennas
Get PDFThis article leverages an automated quantum genetic algorithm (QGA) to design miniaturized antennas for Internet of Things (IoT) devices. The QGA implemented in this work automates the design process and enables the antenna designer to generate static or reconfigurable miniaturized microstrip folded antenna topologies. The QGA is also implemented to generate a pixelation pattern within the antenna radiating surface to optimally tune the antenna operation for IoT communication needs as well as for Wi-Fi operation. In this article, we also present a QGA-optimized folded miniaturized antenna in both static and reconfigurable topologies. The reconfiguration is achieved through a single radio frequency (RF) micro-electro-mechanical switch (RF MEMS) whose location is optimized through the automated process. The automated design process achieves 87% antenna size reduction at 868 MHz compared to a typical patch antenna operating at the same frequency. As a result, the static and reconfigurable antenna prototypes achieve good radiation efficiencies in comparison to their miniature size with acceptable gains thus satisfying the IoT physical and operational constraints. Both antennas are fabricated and tested, where excellent agreement is noticed between simulated and measured results. © 1963-2012 IEEE
The Construction Of a Simplicial Resolution Of l² Where l Is Square-Free Monomial Ideal.
No full textLet R=ĸ[x_1‚…‚x_n] be the polynomial ring in n variables, and I=(m_1‚…‚m_q) a square-free monomial ideal in R. We consider the ideal I²=({m_i m_j:i‚j}) to be the monomial ideal generated by at most ((q+1)¦2) generators. We study the construction of a simplicial complex labeled by the monomials of l² which supports a free resolution of l²
The Genetic Architecture of Vitamin D Deficiency among an Elderly Lebanese Middle Eastern Population: An Exome-Wide Association Study
Get PDFThe Middle East region experiences a high prevalence of vitamin D deficiency, yet most genetic studies on vitamin D have focused on European populations. Furthermore, there is a lack of research on the genomic risk factors affecting elderly people, who are more susceptible to health burdens. We investigated the genetic determinants of 25-hydroxyvitamin D concentrations in elderly Lebanese individuals (n = 199) through a whole-exome-based genome-wide association study. Novel genomic loci displaying suggestive evidence of association with 25-hydroxyvitamin D levels were identified in our study, including rs141064014 in the MGAM (p-value of 4.40 × 10−6) and rs7036592 in PHF2 (p-value of 8.43 × 10−6). A meta-analysis of the Lebanese data and the largest European genome-wide association study confirmed consistency replication of numerous variants, including rs2725405 in SLC38A10 (p-value of 3.73 × 10−8). Although the polygenic risk score model derived from European populations exhibited lower performance than European estimations, it still effectively predicted vitamin D deficiency among our cohort. Our discoveries offer novel perspectives on the genetic mechanisms underlying vitamin D deficiency among elderly Middle Eastern populations, facilitating the development of personalized approaches for more effective management of vitamin D deficiency. Additionally, we demonstrated that whole-exome-based genome-wide association study is an effective method for identifying genetic components associated with phenotypes. © 2023 by the authors
Cooling Down Inflammation in the Cardiovascular System via the Nicotinic Acetylcholine Receptor
Get PDFInflammation is a major player in many cardiovascular diseases including hypertension, atherosclerosis, myocardial infarction, and heart failure. In many individuals, these conditions coexist and mutually exacerbate each other's progression. The pathophysiology of these diseases entails the active involvement of both innate and adaptive immune cells. Immune cells that possess the α7 subunit of the nicotinic acetylcholine receptor on their surface have the potential to be targeted through both pharmacological and electrical stimulation of the cholinergic system. The cholinergic system regulates the inflammatory response to various stressors in different organ systems by systematically suppressing spleen-derived monocytes and chemokines and locally improving immune cell function. Research on the cardiovascular system has demonstrated the potential for atheroma plaque stabilization and regression as favorable outcomes. Smaller infarct size and reduced fibrosis have been associated with improved cardiac function and a decrease in adverse cardiac remodeling. Furthermore, enhanced electrical stability of the myocardium can lead to a reduction in the incidence of ventricular tachyarrhythmia. In addition, improving mitochondrial dysfunction and decreasing oxidative stress can result in less myocardial tissue damage caused by reperfusion injury. Restoring baroreflex activity and reduction in renal damage can promote blood pressure regulation and help counteract hypertension. Thus, the present review highlights the potential of nicotinic acetylcholine receptor activation as a natural approach to alleviate the adverse consequences of inflammation in the cardiovascular system. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved
Towards a national pharmaceutical strategy in Lebanon: E nsuring access to quality and safe medications for all
Get PDFIntroduction: Lebanon is facing challenges affecting the whole health sector, including access to medications. Lebanon has only proposed very few short-term national pharmaceutical strategic solutions. Previous reform attempts targeting the pharmaceutical sector, could not protect it from the crises and their detrimental consequences on patient and population health. Purpose: This document unveils the critical elements that should be addressed in the planned National Pharmaceutical Sector Strategy (NPS) being developed by the Order of Pharmacists of Lebanon (OPL) in consultation with the concerned stakeholders. Method: Strategic goals were proposed for adoption and implementation by the competent authorities based on consultations, situational assessments, and gap analyses. The objectives and an implementation plan were developed based on the available resources and policy dialogue, respectively. Conclusion: The National Pharmaceutical Strategy would help the Lebanese authorities/policy-makers, aided by competent healthcare professionals, develop and implement a time-bound roadmap to attain a nation with access to quality and safe medications for the whole population. Implementing this strategy would require the commitment of decision-makers, the accountability of involved parties, innovation in finding solutions, close collaboration between stakeholders, and lengthy efforts to attain the stated vision. © 2023, International Pharmaceutical Federation. All rights reserved